'A Hidden America: Children of the Mountains'Diane Sawyer Reports on America's Children Living in Poverty in Appalachia Feb. 10, 2009

In the hills of Central Appalachia, up winding, mountain roads, is a place where children and families face unthinkable conditions, living without what most Americans take for granted.

Erica, 11, has tried for years to help her mom kick a powerful drug habit.

Isolated pockets in Central Appalachia have three times the national poverty rate, an epidemic of prescription drug abuse, the shortest life span in the nation, toothlessness, cancer and chronic depression.

It's been 41 years since Robert Kennedy called on the rest of America to reach out and help the people of Appalachia. These are the descendents of Davey Crockett, Daniel Boone, Loretta Lynn and Patsy Cline and the families of legendary soldiers and pioneers who helped open up the treacherous mountain passes and create an American continent. They are fighters steeped in family, ferocity and faith.

For nearly two years, ABC News cameras followed four Appalachian children, each one facing unimaginable obstacles.

Shawn Grim, 18, an Appalachian high school football superstar, sleeps in his truck to avoid the thievery, alcoholism and despair of his family's life in the hollow in Flat Gap, Ky. During the course of Sawyer's report, Grim moves eight times. He is determined to be the first one in his family to graduate from high school and go to college. Will he be able to achieve his dream of a different life?

Courtney, 12, is one of those children whose face reminds us of the famous portraits of the Appalachian past. Her clothes are stuffed in a suitcase under her bed in the small home she shares with 11 relatives in Inez, Ky. Her mother, Angel, struggles to stay off drugs and hopes to give her four daughters a better life by getting her GED and becoming a teacher. With no car and no public transportation, Angel walks 16 miles roundtrip, four hours total, to her GED class.

Erica, 11, hopes to save her mother's life: "She's almost 50 and… if I don't get her out of this town soon, then she'll probably die any day." Erica and her mother, Mona, live in Cumberland, Ky., a once booming coal town. Mona battles addiction to prescription drugs and alcohol, her life ravaged by her struggles and despair. The region has a prescription drug abuse rate twice that of major cities like New York or Miami.

When his girlfriend becomes pregnant, Jeremy, 18, trades his dream of a life as an engineer in the military for a life underground in the coal mines. Sawyer travels down 3½ miles to the dangerous working face of the mine to meet Jeremy and the other men who work nine to 12 hours a day, six days a week, with little sunshine in their daily lives. But despite the safety concerns, it is the best paying job in the region.

Courtney, 12, lives in Appalachia. Her clothes are stuffed in a suitcase under her bed in the small home she shares with 11 relatives in Inez, Ky. Her mother, Angel, struggles to stay off drugs and hopes to give her four daughters a better life by getting her GED and becoming a teacher.

There are also heroes in the hills -- teachers, social workers, doctors and dentists reaching out to a population isolated by the steep hills and lack of transportation.

Nicknamed the Mother Teresa of Mud Creek, Eula Hall, 81, has spent 36 years transporting the sick out of the hills and into her clinic. Working with her is Dr. Anant Chandel, born and raised in India.

"It's hard to believe but yes… people are poorer in this part of the country than where I was in India," he said.

Another hero of the mountains is Dr. Edwin Smith of Barbourville, Ky. He used $150,000 of his own money to convert a truck into a mobile dental office. Dentists say Central Appalachia is first in the country for toothlessness. One of out 10 residents is completely without teeth and children as young as 2 already have as many as 12 cavities.

"A Hidden America: Children of the Mountains" is a continuation of Diane Sawyer's reporting on America's forgotten children. Sawyer won an Emmy for outstanding feature story in a news magazine for "Waiting on the World to Change," a firsthand account of poverty among children in America, which aired in 2007. The yearlong reporting followed the lives of children in one of the poorest cities in America who struggle daily to succeed despite horrendous odds.

Diane Sawyer examines poverty in AppalachiaThe journalist returns to a place she knows to document its poverty.By Matea Gold February 11, 2009

Reporting from New York -- Friday's “20/20” finds Diane Sawyer in starkly different environs than the cheerily lighted Times Square studio she occupies each morning as co-host of “Good Morning America.”

In her latest ABC prime-time special, which examines poverty in Appalachia, Sawyer is scrubbed free of the glamour of morning television. Donning blue jeans, her normally coiffed hair pulled back in a ponytail, the anchor visits the deepest recesses of the mountainous region: the hillside trailer homes, the weathered front porches, the dank tunnels of a coal mine.

For Sawyer, it is not unfamiliar turf. She was born in Glasgow, Ky., and her family's ties to Appalachia stretch back decades.

"You don't have to go many generations back before we were up there fighting our way through those passes and trying to make our way down the mountain like everybody else," said Sawyer, who covered the region as a young Louisville television reporter in the late 1960s. "I'm always so moved by the bravery and the vitality of these essential American fighters. And now they've got a battle that they aren't winning."

"A Hidden America: Children of the Mountains" is the latest in a series of prime-time specials about poverty Sawyer has done in the last several years, including a 2007 piece that profiled the lives of children in Camden, N.J.

"It gets me up in the morning," she said of the documentaries, sitting in her cozy corner office at ABC on a recent afternoon, a flock of gilded Emmys perched on her desk. She jumped up to show a reporter the grinning school photo of one of the boys from the Camden special pinned to the wall, along with two colorful pieces of artwork he made for her.

Sawyer said she has not tired yet of "GMA," even after a decade of rising before dawn. But to do the morning program, she said, she needs an outlet for more substantial fare.

"This is what I think of as my life's work," she said. "I just feel hope when I do them, because we can do something about this. I can't do anything about government stimulus for banks' toxic assets -- even if I understood it, I couldn't do anything about it. But this I can do something about."

And it's not something the network would begrudge Sawyer, who remains one of ABC's most bankable stars. Since "Primetime," the news magazine she has co-anchored for 20 years, no longer has a regular time slot, Sawyer's recent specials have aired on "20/20," the longtime home of Barbara Walters, who had Sawyer on "The View" on Monday to promote her latest piece.

The impetus for "A Hidden America" came from Sawyer's personal ties to Appalachia, she said, and a sense that the region was forgotten.

"I think that urban poverty, while often crushing and inestimable, doesn't have the isolation," she said.

Friday's special shows how a lack of transportation deepens the effects of depravation: one of the women in the piece, Angel, trudges eight miles down the mountain every day to reach her GED class.

Sawyer's producing team worked on the project for two years, traveling more than 14,000 miles in the process. The anchor herself made one "very intense" trip to the region. She interviewed children like 11-year-old Erica, who desperately wants her mother to kick her drug habit. When Sawyer asks her why she believes her mother keeps using, the young girl replies world-wearily: "Pain. Misery." Equally compelling are the stories of Shawn Grim, an 18-year-old football phenom who lives in his truck to escape the dysfunction at home, and Courtney, 12, whose family often runs out of food.

Sawyer admits she doesn't know if viewers have an appetite for such difficult material.

"We don't ask ourselves that," she said. "Although I would argue to people watching that seeing these kids fight is a pretty good booster shot for anything going on in your life. But we're not doing these for numbers and ratings. We're doing these because we want to stay in the center of our purpose."

The somber tenor of "A Hidden America" is a dramatic departure from "GMA," which goes "from troops in Afghanistan to Valentine's presents with breathtaking velocity," Sawyer noted with a laugh.

Since coming close to catching up with top-rated "Today" in 2005, "GMA" has fallen back, averaging a million fewer viewers this season than its NBC rival. Sawyer says the gap is not surprising, considering the program's on-air team has been almost completely remade in the last three years.

Sawyer, the only one who has remained constant, was actually only supposed to be on the show temporarily. She and Charles Gibson agreed to help right the program in 1999 after the disastrous pairing of Lisa McRee and Kevin Newman. Gibson moved on to "World News" in 2006, but Sawyer is still helming "GMA," now with co-host Robin Roberts, without any firm time commitment.

"It's an ongoing conversation, which is how I like it," she said. "And no one has to feel it's an obligation."

"As long as it's still fun and surprising and our team is as linked at the elbows as we are, I can keep doing it," she added. "I don't know that it's anything that you can foresee. Some day, you'll just know it's time to phase down and out."

Sawyer's contract with ABC is reportedly set to expire sometime this year, and she confirmed that she has not yet renewed her deal.

"At some point I'll get to it," she said. (A network source said there is "plenty of time" left on her contract.)

Central to the negotiations will be the question of what Sawyer wants to do next, a topic the anchor is notoriously circumspect about. She side-stepped a question about whether she hopes to succeed Gibson on "World News" after he retires.

"You know, I feel the same way I've always felt: You never know until the moment about what you want to do next in this world," Sawyer said. "I've never been able to plan ahead and say, 'That's my aim, that's my goal,' because the thing you think may hold the most emotional and journalistic riches for you will turn out to be something that is not what you want to do at all. So I don't think that way. And to me, it's about the chance to have the biggest possible palette on which to do the things I think matter."

My friend and I are watching this right now. Wow. Seriously. It is so hard to believe that places like this still exist in the US. I hope this high school football player gets a scholarship to college and can get the hell away from there, make a life for himself. I wish I could adopt him. All he wants is a place to sleep, and my couch is better than his truck

"All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves; we must die to one life before we can enter another." -Anatole France

SisMorphine wrote: It is so hard to believe that places like this still exist in the US.

And that's why it bugs the crap out of me that celebrities are boo-hooing about how horrible the rest of the world is and they have to fix other countries, yet we have the same poverty right here on our own land.

Back in the late 80s when he was still a teen, my brother and his friends hiked the Trail and they were SHOCKED at the poverty they saw. They took time out of their hike to help a family with fixing up their home. To this day, my bro still donates to Appalachian charities.

Never make someone a priority in your life when that someone treats you like an option.

So after watching that I'm even more determined to make a life for myself and be able to adopt older kids who really want to succeed but who's families hold them back. Sad sad hour of television. Sad way of life in forgotten America

"All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves; we must die to one life before we can enter another." -Anatole France

Marinepits wrote:And that's why it bugs the crap out of me that celebrities are boo-hooing about how horrible the rest of the world is and they have to fix other countries, yet we have the same poverty right here on our own land.

I agree with you, Jen. I also get a little annoyed when they adopt children from other countries. I realize it is a LIFE, no matter how you look at it, but what about the unwanted children here?

If the adoption rules are too difficult here, then they should be changed. I don't know much about it, but maybe that is what is keeping people from adopting from their own backyard, so to speak?